Provider Demographics
NPI:1467870634
Name:INOVA HEALTHCARE, INC
Entity Type:Organization
Organization Name:INOVA HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DEME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-445-6518
Mailing Address - Street 1:PO BOX 22567
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33335-2256
Mailing Address - Country:US
Mailing Address - Phone:844-446-6824
Mailing Address - Fax:888-972-1840
Practice Address - Street 1:3412 GRIFFIN ROAD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312
Practice Address - Country:US
Practice Address - Phone:844-446-6824
Practice Address - Fax:888-972-1840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier